Provider Demographics
NPI:1306140637
Name:OSENI, RIVY OLASUMBO (NP)
Entity type:Individual
Prefix:
First Name:RIVY
Middle Name:OLASUMBO
Last Name:OSENI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3625 DEL AMO BLVD
Mailing Address - Street 2:STE 120
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-1668
Mailing Address - Country:US
Mailing Address - Phone:310-512-8104
Mailing Address - Fax:310-324-2111
Practice Address - Street 1:23860 HAWTHORNE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-8201
Practice Address - Country:US
Practice Address - Phone:310-791-3064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-30
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA19892363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner